Homeostasis Model Assessment-estimated Insulin Resistance Research Articles

Study on the effect of vitamin D on obesity and fatty liver induced by monosodium glutamate in male albino rats

Background One of the most common hepatic disorders is nonalcoholic fatty-liver disease. The best model used for nonalcoholic fatty-liver disease is the monosodium glutamate (MSG)-induced obesity. MSG is a common flavor enhancer used in different food products. Vitamin-D deficiency increased risks of obesity and nonalcoholic fatty-liver disease. However, much is still unknown about the link between vitamin D and nonalcoholic fatty-liver disease in obesity. Aim The aim was to investigate the effect of vitamin D on MSG-induced obesity and nonalcoholic fatty-liver disease in rats. Materials and methods Forty adult male albino rats were divided into four equal groups: control group, vitamin-D-treated group, MSG-treated group, MSG, and vitamin-D-treated group, at the end of the experimental period, blood samples were taken. Also, livers were dissected for histopathology. Results Vitamin D+MSG significantly decreased the body weight, serum levels of glucose, insulin and homeostasis model assessment-estimated insulin resistance, triglycerides, tumor necrosis factor-alpha, aspartate aminotransferase, alanine aminotransferase, and the liver malondialdehyde, while increased the liver glutathione levels and improved the liver histological findings compared with MSG group. Conclusion Vitamin D has a hepatoprotective effect on the MSG-induced obesity and nonalcoholic fatty-liver disease.

The Effect of Traditional Aerobic Exercise and Sprint Interval Training on Insulin Resistance in Men With Prediabetes: A Randomised Controlled Trial.

IntroductionPrediabetes is an intermediate stage with hyperglycaemia below the threshold of diabetes mellitus. Insulin resistance is a significant factor in its pathogenesis. Lifestyle modifications are suggested and found to be more beneficial in this stage. Moderate-intensity exercise for 30 to 45 minutes a day is routinely recommended but has low compliance, and lack of time is a significant deterrent. Sprint interval training (SIT) is an alternate exercise regimen with higher intensity and less time requirement. The present study compares the effect of a three-month intervention of traditional aerobic exercise and sprint interval training on insulin resistance in prediabetic men.MethodsThe study subjects were males aged 25 to 40 years with prediabetes as per the American Diabetes Association criteria of fasting and two-hour plasma glucose levels. The study is a parallel-group randomised trial with one arm (AE group) involved in the traditional aerobic exercise (brisk walking) for 30 minutes, five days a week. The other arm was the sprint interval training (SIT) group performing an ‘all-out’ run effort for one minute followed by a recovery rest period of one and a half minutes, completing one cycle of two and half minutes. Four such cycles were completed in each session. Thus, the exercise sessions were just 10 minutes daily, three days a week. The duration of the intervention was three months. One hundred and sixty participants were recruited after screening and randomly assigned in a 1:1 ratio to the two groups. The primary outcome measure was insulin resistance estimated by homeostasis model assessment -estimated insulin resistance (HOMA-IR). The secondary outcome measures were fasting plasma glucose and serum insulin, glycated haemoglobin, body mass index and waist-hip ratio.ResultsThe mean age of the AE group was 30.7 ± 3.3 years, and the SIT group was 31 ± 3.4 years. Seventy-two men from the AE group and 74 from the SIT group completed the study. After the three-month AE and SIT exercise, the per-protocol analysis reflected a significant reduction in insulin resistance, i.e., HOMA-IR (3.6 ± 1.1 to 3 ± 1.2, p<0.0001) after traditional aerobic exercise. Similarly, the HOMA-IR was significantly reduced after sprint interval training (3.3 ± 1.2 to 2.5 ± 1, p<0.0001). The intention-to-treat analysis also found that the reductions in HOMA-IR after both exercise protocols were statistically significant. The change in insulin resistance compared for the SIT vs AE group was not statistically significant. Secondary outcome measures HbA1c, fasting glucose, fasting insulin, BMI, and waist-hip ratio showed significant improvement with AE and SIT. ConclusionsThe sprint interval training similarly improved insulin resistance and other parameters compared to the traditional exercise group. SIT can be a time-efficient exercise protocol suggested as a part of lifestyle modification for men with prediabetes.

The effect of vitamin D supplementation on tobacco-related disorders in individuals with a tobacco use disorder: a randomized clinical trial

Vitamin D deficiency in cigarette smokers (CS) might associate with several complications, including metabolic deficits, depression and anxiety. This study evaluated the effects of vitamin D on mental health symptoms, nicotine misuse, and biomarkers of metabolic diseases in individuals with a tobacco use disorder. A randomized, double-blind, placebo-controlled trial was conducted with 60 CS subjects receiving either 50,000 IU vitamin D supplements (n = 30) or placebo (n = 30) every 2 weeks for 24-weeks. Nicotine misuse, mental health scale, and metabolic parameters were measured before and after the intervention in the CS subjects. Compared with the placebo-group, after the 24-weeks intervention, serum 25 (OH) vitamin D levels increased in the intervention group (β 2.96; 95% CI, 0.91, 5.01; P = 0.006). In addition, vitamin D supplementation significantly improved Beck Depression Inventory (BDI) (β −2.06; 95% CI, −3.84, −0.28; P = 0.02). In addition, vitamin D administration significantly decreased fasting plasma glucose (FPG) (β −4.56; 95% CI, −8.94, −0.19; P = 0.04), insulin (β −0.50; 95% CI, −0.88, −0.13; P = 0.009), and homeostasis model of assessment-estimated insulin resistance (HOMA-IR) levels (β −0.21; 95% CI, −0.33, −0.08; P = 0.001). Furthermore, vitamin D resulted in a significant elevation in total antioxidant capacity (TAC) (β 81.20; 95% CI, 18.30, 144.11; P = 0.01), and plasma glutathione (GSH) levels (β 73.05; 95% CI, 18.56, 127.54; P = 0.01), compared with the placebo-group. Administration of vitamin D for 24-weeks to CS subjects had beneficial effects on symptoms of depression and several metabolic biomarkers. While this preliminary study suggests that vitamin D might have beneficial effects, its clinical efficacy in individuals with a tobacco use disorder should be further validated in future clinical trials.

Impaired glucose metabolism reduces the neuroprotective action of adipocytokines in cognitively normal older adults with insulin resistance.

Evidence suggests that aging-related dysfunctions of adipose tissue and metabolic disturbances increase the risk of diabetes and metabolic syndrome (MtbS), eventually leading to cognitive impairment and dementia. However, the neuroprotective role of adipocytokines in this process has not been specifically investigated. The present study aims to identify metabolic alterations that may prevent adipocytokines from exerting their neuroprotective action in normal ageing. We hypothesize that neuroprotection may occur under insulin resistance (IR) conditions as long as there are no other metabolic alterations that indirectly impair the action of adipocytokines, such as hyperglycemia. This hypothesis was tested in 239 cognitively normal older adults (149 females) aged 52 to 87 years (67.4 ± 5.9 yr). We assessed whether the homeostasis model assessment-estimated insulin resistance (HOMA-IR) and the presence of different components of MtbS moderated the association of plasma adipocytokines (i.e., adiponectin, leptin and the adiponectin to leptin [Ad/L] ratio) with cognitive functioning and cortical thickness. The results showed that HOMA-IR, circulating triglyceride and glucose levels moderated the neuroprotective effect of adipocytokines. In particular, elevated triglyceride levels reduced the beneficial effect of Ad/L ratio on cognitive functioning in insulin-sensitive individuals; whereas under high IR conditions, it was elevated glucose levels that weakened the association of the Ad/L ratio with cognitive functioning and with cortical thickness of prefrontal regions. Taken together, these findings suggest that the neuroprotective action of adipocytokines is conditioned not only by whether cognitively normal older adults are insulin-sensitive or not, but also by the circulating levels of triglycerides and glucose, respectively.

Effects of Non-periodized and Linear Periodized Combined Exercise Training on Insulin Resistance Indicators in Adults with Obesity: A Randomized Controlled Trial

BackgroundThe aim was to verify the effect of non-periodized and linear periodized combined (aerobic plus resistance) exercise training on insulin resistance markers in adults with obesity.MethodsA blinded randomized control trial was conducted with three groups of individuals with obesity (BMI, 30–39.9 kg/m2): control group (CG, n = 23), non-periodized group (NG, n = 23), and linear periodized group (PG, n = 23). The NG and PG performed aerobic and resistance exercises in the same session in aerobic-resistance order for 16 weeks. Both intervention groups trained three sessions weekly, with a total duration of 60 min each. The aerobic training of the NG had a duration of 30 min always between 50% and 59% of the reserve heart rate (HRres), while resistance exercise was comprised of 6 exercises, performed always in 2 × 10–12 maximum repetitions (MRs). The PG progressed the aerobic and resistance training from 40%–49% to 60%–69% (HRres) and from 2 × 12–14 to 2 × 8–10 RM, respectively, along the intervention period. The evaluated indicators of insulin resistance included fasting glucose, fasting insulin, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) collected pre- and post-intervention. The analyses to verify the exercise training effect were performed using generalized estimating equations.ResultsAfter 16 weeks of training, per protocol analysis (n = 39) showed significant reductions in HOMA-IR only in the training groups (NG: Δ = − 1.6, PG: Δ = − 0.6; p = 0.094). Intention-to-treat analysis demonstrated significant reductions in fasting insulin levels (NG: Δ = − 1.4, PG: Δ = − 1.0; p = 0.004) and HOMA-IR (NG: Δ = − 5.5, PG: Δ = − 3.8; p = 0.002).ConclusionPeriodized and non-periodized combined exercise training similarly reduces insulin resistance markers in adults with obesity.Trial registration: Brazilian Registry of Clinical Trials, RBR-3c7rt3. Registered 07 February 2019—https://ensaiosclinicos.gov.br/trial/5970/1.

Breast Cancer-related Biomarkers And Weight Regain Following An Exercise Intervention In Postmenopausal Women

PURPOSE: To assess the strength of the associations between breast cancer-related biomarkers and weight regain following exercise-induced weight loss in postmenopausal women. METHODS: The Breast Cancer and Exercise Trial in Alberta (BETA) included 400 participants that were randomized to either 150 or 300 minutes/week of aerobic exercise over 12 months with follow-up measurements at 24 months. During the follow-up period, no exercise intervention was prescribed. For these secondary analyses, we included participants who lost weight during the intervention and who had follow-up blood samples, body composition and covariate measurements (n = 214). Outcomes were measured at baseline, 12 months and 24 months. Linear regression models were used to explore associations between changes in body weight during follow-up, with changes in serum levels of breast-cancer related biomarkers: estradiol, free estradiol, estrone, sex hormone-binding globulin (SHBG), insulin, homeostasis model assessment-estimated insulin resistance (HOMA-IR), and C-reactive protein (CRP). RESULTS: Weight regain during follow-up was significantly associated with increases in estradiol (treatment effect ratio (TER) = 1.03, 95% CI: 1.01, 1.04), estrone (TER = 1.02, 95% CI: 1.01, 1.03), free estradiol (TER = 1.04, 95% CI: 1.02, 1.05), HOMA-IR (TER = 1.03, 95% CI: 1.02, 1.05), insulin (TER = 1.03, 95% CI: 1.01, 1.04), and decreases in SHBG (TER = 0.98, 95% CI: 0.97, 0.99) levels. Non-statistically significant associations were found for glucose and CRP. Furthermore, categorical results revealed increases in estradiol, free estradiol, insulin, HOMA-IR and CRP for participants who regained any amount of weight compared with those who continued to lose or maintained weight loss during follow-up. CONCLUSION: Weight regain after an exercise intervention is associated with increases in estradiol, free estradiol, estrone, insulin, and decreases in SHBG in postmenopausal women. Future studies should analyze other blood biomarkers and tissue-specific markers that increase breast cancer risk, and their associations with weight regain following exercise-induced weight loss. Sources of funding: Research Grant No. 24404 from the Alberta Cancer Foundation and No. 2011-701000 by the Canadian Cancer Society.

Hypoglycemic peptide-enriched hydrolysates of Corbicula fluminea and Chlorella sorokiniana possess synergistic hypoglycemic activity through inhibiting α-glucosidase and dipeptidyl peptidase-4 activity.

The prevalence of diabetes mellitus worldwide has increased in recent decades. Maintaining the level of blood glucose is the most basic and important issue for diabetics. This study aimed to investigate the hypoglycemic activity of a combination of hypoglycemic peptide-enriched hydrolysates of Corbicula fluminea (ACH) and Chlorella sorokiniana (PCH). Combined supplementation of ACH and PCH synergistically inhibited α-glucosidase and DPP4 activities in vitro. After 4 weeks of treatment with ACH and/or PCH, the plasma glucose concentration and insulin, homeostasis model assessment-estimated insulin resistance (HOMA-IR), total cholesterol (TC) and triglyceride (TG) levels significantly decreased. The hypoglycemic peptides in ACH and PCH were purified and assayed for α-glucosidase and DPP4 activity. The hypoglycemic peptides in ACH and PCH effectively decreased α-glucosidase and DPP4 activities. In silico assays showed that these two peptide types have different docking poses, which determined their inhibitory effect against α-glucosidase and DPP4 activity. Combined treatment with hypoglycemic peptide-enriched ACH and PCH could modulate blood glucose by synergistically inhibiting α-glucosidase and DPP4 activities. © 2021 Society of Chemical Industry.

Gut Microbiota Signature Among Asian Post-gestational Diabetes Women Linked to Macronutrient Intakes and Metabolic Phenotypes

Aberrant gut microbiota dysbiosis in women with a previous history of gestational diabetes mellitus (post-GDM) was comparable to that in adults with type 2 diabetes mellitus (T2DM). Nonetheless, potential relationships between diet, gut microbiota, and metabolic phenotypes in post-GDM women after delivery are yet to be discovered. In this research, we assessed the relationship of the macronutrient intakes, gut microbiota composition, and metabolic phenotypes (i.e., anthropometrics and glycemic control) in post-GDM women with and without postpartum glucose intolerance (GI). About 24 post-GDM women were included in this study, 14 women were grouped in the GI group and 10 women were grouped in the normal glucose tolerance (NGT) group according to oral glucose tolerance test. Macronutrient intake assessment using a 3-day dietary record, anthropometric measurements, biochemical analyses, and fecal sampling were done during 3–6 months postpartum. Gut microbiota profiling was determined using 16S rRNA genes sequencing targeting the V3–V4 regions. The relationships between macronutrient intakes, gut microbiota composition, and metabolic phenotypes were evaluated using Pearson’s correlation coefficient and stepwise regression analyses. In this study, most post-GDM women had significantly poor dietary fiber adherence than the nutritional recommendations. Women from the GI group have significantly higher fasting blood glucose (FBG), HbA1c, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) levels compared to the NGT group. The group also showed significant elevation of high-sensitivity C-reactive protein (hs-CRP) level when compared to the normal value. Specific gut microbial taxa derived from Proteobacteria and Bacteroidetes such as Parasutterella, Aquicella, Haliscomenobacter, and Prevotellaceae_NK3B31_group were significantly abundant in the GI group compared to the NGT group. Prevotellaceae_NK3B31_group was significantly associated with high FBG, HOMA-IR, and HbA1c levels. Low fiber and monounsaturated fatty acids intakes were associated with Lactobacillus. Meanwhile, Lactobacillus was associated with high body mass index, waist circumference, 2-h postprandial blood glucose, and hs-CRP levels. Our study suggested that macronutrient intake is an important predictor of gut microbiota dysbiosis and is associated with obesity, low-grade inflammation, and poor glycemic control in post-GDM women. Hence, dietary intake modification to remodel gut microbiota composition is a promising T2DM preventive strategy in post-GDM women.

Impact of Acute Insulin Resistance on Myocardial Blush in Non-Diabetic Patients Undergoing Primary Percutaneous Coronary Intervention.

Background: Myocardial blush grading is considered to be a novel tool for assessment of coronary microvasculature and myocardial perfusion in patients undergoing coronary angiography and angioplasty, and its reduction identifies patients at high risk. Our study aimed to evaluate the association between acute insulin resistance and myocardial blush in non-diabetic patients with ST-segment elevation myocardial infarction (STEMI).Methods: Two hundred forty non-diabetic patients with STEMI who underwent primary percutaneous coronary intervention were consecutively recruited. The relationship of homeostasis model assessment—estimated insulin resistance (HOMA-IR) to myocardial blush and in-hospital outcome was investigated.Results: Higher HOMA-IR tertile was observed in obese patients, with hyperinsulinemia, had Killip class >1, with higher CPK-MB level and was correlated to impaired myocardial blush after adjusting for the other confounding risk factors. It was also concluded that higher HOMA-IR was independently associated with no/minimal myocardial blush after STEMI. Moreover, it was founded to be an independent predictor of pulmonary edema and impaired left ventricular systolic function.Conclusion: This study revealed that acute insulin resistance was prevalent in non-diabetic patients with STEMI and was an independent predictor for post-infarction myocardial and microvascular injury and poor in-hospital outcome.Trial Registration: The trial was registered at the registry of Clinicaltrials.gov, ClinicalTrials.gov Identifier: NCT04651842, Date of registration: 2nd December 2020 Registry URL, https://clinicaltrials.gov/ct2/show/NCT04385589?cond=Dapagliflozin+in+diabetic+patients&cntry=EG&draw=2&rank=1.

Investigating Insulin Resistance in Pediatric Cardiomyopathy - A Pilot Study

Children with cardiomyopathy are a vulnerable population and understanding the factors that contribute to cardiac dysfunction are of great importance. At the biochemical level, energy utilization by cardiomyocytes during stress may provide insight into the progression of cardiomyopathy. There is a large body of literature that describes insulin resistance in adults with cardiomyopathy (1,2). Extensive literature on the topic in adult individuals exists however investigation in the pediatric population is sparse. The pathophysiology of disease in children and adolescents is unique. To study the role of insulin resistance in pediatric cardiomyopathy, we measured the homeostasis model assessment-estimated insulin resistance (HOMA-IR) at baseline in pre-pubertal patients (age 13-18 years old; mean 16 years old; n = 8) with either hypertrophic cardiomyopathy (HCM) or dilated cardiomyopathy (DCM). In patients with HCM, greater insulin resistance was positively correlated with greater left ventricular (LV) septal thickness (r = 0.55; p = 0.33; n = 5) and LV posterior wall thickness (r = 0.7; p = 0.19; n = 5) during diastole. As expected, insulin resistance was strongly correlated with BMI (r = 0.84; p = 0.08; n = 5) though greater BMI was not as strongly associated with LV septal thickness (r = 0.59; p = 0.3; n = 5) or posterior wall thickness (r = 0.59; p = 0.3; n = 5). In patients with DCM, insulin resistance was positively correlated with LV end diastolic volume (r = 0.59; p = 0.59; n = 3). Interestingly, there was an observed inverse association between insulin resistance and BMI in DCM (r = -0.85; p = 0.34; n =3). Though our sample population is limited, thus affecting statistical significance, results showed that there was a trend towards greater insulin resistance in patients with poorer cardiac measurements. These findings are consistent with adult literature and the proposition that cardiac dysfunction is an insulin resistant state.

Effects of supplementation with main coffee components including caffeine and/or chlorogenic acid on hepatic, metabolic, and inflammatory indices in patients with non-alcoholic fatty liver disease and type 2 diabetes: a randomized, double-blind, placebo-controlled, clinical trial

BackgroundNon-alcoholic fatty liver disease (NAFLD) is much more frequent and more severe, including cirrhosis, hepatocellular carcinoma in patients with type 2 diabetes. Coffee is a complex beverage with hundreds of compounds whereas caffeine and chlorogenic acid are the most abundant bioactive compounds. The published epidemiological data demonstrating beneficial associations between all categories of coffee exposure and ranges of liver outcomes are rapidly growing; however, the main contributors and cause-effect relationships have not yet been elucidated. To address existing knowledge gaps, we sought to determine the efficacy and safety of 6 months chlorogenic acid and/or caffeine supplementation in patients with type 2 diabetes affected by NAFLD.MethodsThis trial was carried out at two Diabetes Centers to assess the effects of supplementation with daily doses of 200 mg chlorogenic acid, 200 mg caffeine, 200 mg chlorogenic acid plus 200 mg caffeine or placebo (starch) in patients with type 2 diabetes and NAFLD. The primary endpoint was reduction of hepatic fat and stiffness measured by FibroScan, and changes in serum hepatic enzymes and cytokeratin − 18 (CK-18) levels. Secondary endpoints were improvements in metabolic (including fasting glucose, homeostasis model assessment-estimated insulin resistance (HOMA-IR), hemoglobin A1c (HBA1C), C-peptide, insulin and lipid profiles) and inflammatory (including nuclear factor k-B (NF-KB), tumor necrosis factor (TNF-α), high sensitive- C reactive protein(hs-CRP)) parameters from baseline to the end of treatment.ResultsNeither chlorogenic acid nor caffeine was superior to placebo in attenuation of the hepatic fat and stiffness and other hepatic outcomes in patients with diabetes and NAFLD. Except for the lower level of total cholesterol in caffeine group (p = 0.04), and higher level of insulin in chlorogenic acid plus caffeine group (p = 0.01) compared with placebo, there were no significant differences among the treatment groups.ConclusionThese findings do not recommend caffeine and/or chlorogenic acid to treat NAFLD in type 2 diabetes patients.Trial registrationIRCT201707024010N21. Registered 14 September 2017.

Fatty Liver Is Associated with Low N-Terminal Pro-B-Type Natriuretic Peptide in a Healthy Population.

Fatty liver (FL), insulin resistance (IR) and obesity often coexist, but data on the independent impacts of these factors on N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels are scarce. We examined the impact of FL, IR and obesity on NT-proBNP levels using a large set of cross-sectional data. The associations of FL, IR and obesity with NT-proBNP were analyzed in 39,923 healthy adult participants. IR was estimated using a homeostasis model assessment-estimated insulin resistance (HOMA-IR) index. A multivariable regression model was conducted to identify associations between NT-proBNP and FL on abdominal ultrasound. FL, IR and obesity showed independent inverse associations with NT-proBNP after multiple adjustments for baseline characteristics. In a multivariable regression model adjusting for IR and obesity, FL was independently associated with lower levels of NT-proBNP (estimates, Exp(β) 0.864, 0.849–0.880). The combination of FL and IR was a powerful dual indicator, lowering NT-proBNP levels approximately 25% in the generally healthy study population. In conclusion, FL was independently associated with lower NT-proBNP levels. FL and a high HOMA-IR index are a powerful indicator combination for lower NT-proBNP levels. Further research is needed to elucidate the mechanism underlying the association between FL and NT-proBNP.

The effect of cumin (Cuminum cyminum L.) supplementation on glycemic indices: A systematic review and meta-analysis of randomized controlled trials.

We aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effect of cumin supplementation on markers of glycemic control in adults. A comprehensive literature search was conducted up from inception to November 2020 on PubMed, Scopus, Web of Sciences, and Cochrane electronic databases. Studies that compared the effect of cumin with placebo on fasting blood sugar (FBS), serum insulin, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) index in adults were considered eligible. Weighted mean difference (WMD) (with 95% confidence intervals) for endpoints were calculated using the random-effects model. Finally, a total of eight RCT studies involving 552 participants were included in the review. The results of the meta-analysis suggest that cumin supplementation did not significantly alter serum FBS (WMD: -17.77 mg/dl; 95% CI: -36.42 to 0.87, p= .06), insulin (WMD: -0.49 Hedges' g; 95% CI: -1.19 to 0.21, p=.16) levels and HOMA-IR (WMD: -0.06; 95% CI: -0.21 to 0.10, p= 0.48) index. These results do not support the use of cumin supplementation for improving glycemic markers in adults. However, further high-quality trials are still needed to confirm these results.

Effect of synbiotics and probiotics supplementation on autoimmune diseases: A systematic review and meta-analysis of clinical trials

Today synbiotics are considered as immunomodulatory agents. The current systematic review and meta-analysis investigated the effect of synbiotics and probiotics on inflammatory and oxidative stress markers in autoimmune disease. The English literature search was performed using PubMed, Scopus, Web of Science, and the Central Cochrane Library through March 2020. Random effects models and generic inverse variance methods were used to synthesize quantitative data by STATA14. From a total of 623 entries identified via searches, ten RCTs (n=440; 216 as intervention, 224 as controls) were included. An additional eleven studies with same intervention and different markers were also explained systematically. The pooled effect size showed that Interleukin (IL)-6 (WMD=-7.79pg/ml; 95% CI=-13.81,-1.77, P=0.011), Tumor Necrosis Factor (TNF)-α (WMD=-1.05pg/ml; 95% CI=-2.01,-0.10, P=0.030), high sensitivity C-Reactive Protein (hs-CRP) (SMD=-0.58; 95% CI=-0.79,-0.37, P<0.001), Malondialdehyde (MDA) (SMD=-0.36; 95% CI=-0.68,-0.04; P=0.026), Homeostasis Model of Assessment-estimated Insulin Resistance (HOMA-IR) (WMD=-0.71; 95% CI=-1.05,-0.37, P<0.001), and beta cell function (HOMA-β) (WMD=-15.18; 95% CI=-22.08,-8.28, P<0.001) changed following probiotics (or synbiotics) supplementation. Also supplementation with doses more than 2 billion CFU could reduce IL-10 concentrations (WMD=-1.84; 95% CI=-2.23, 1.87; P<0.001). Glutathione (GSH) and Total Antioxidant Capacity (TAC) levels did not influence by synbiotics and probiotics; insignificancy was remained after subgrouping for participants' age, study duration, and disease duration. Our findings revealed that synbiotics and probiotics supplementation has significant effect on some inflammatory and oxidative stress markers; although, the number of trials was too small to powerful conclusion and further investigations may be needed.

Insulin Resistance is Significantly Related with Worse Clinical Outcomes in Non-Diabetic Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis

Objectivesto investigate the relationship between insulin resistance (IR) and clinical outcomes in non-diabetic ischemic stroke patients treated with intravenous thrombolysis. MethodsWe recruited non-diabetic ischemic stroke patients treated with intravenous thrombolysis prospectively. IR was defined as homeostasis model assessment–estimated insulin resistance index ≥2.80. Initial stroke severity was assessed using the National Institutes of Health Stroke Scale scores, and infarct volume was measured using DWI. Clinical outcomes were evaluated by neurological improvement and hemorrhagic transformation at 24 hours, and favorable functional prognosis at 90 days. Results232 patients were enrolled into this study. IR group was 67 patients, non-IR group was 165 patients. Compared with the non-IR group, the probability of neurological improvement at 24 h ours and favorable functional outcome at 90 days in IR group were all significantly lower (41.79% vs 63.03%, p<0.01; 73.13% vs 89.09%, p<0.01 respectively), whereas the ratio of hemorrhagic transformation was much higher (16.42% vs 4.85%, p<0.01). In multivariable logistic regression, IR was negatively associated with neurological improvement and favorable functional prognosis (OR=0.39, 95%CI, 0.20–0.76, p<0.01; OR= 0.26, 95%CI, 0.07–0.91, p=0.04, respectively), but was positively correlated with hemorrhagic transformation (OR=4.07, 95%CI, 1.13–14.59, p=0.03) after adjusting traditional risk factors. We analyzed 108 infarct volume data further, the median of volume in IR group was 2.27 cm3, higher than that in non-IR group (1.96 cm3), but no statistical difference (p=0.65). ConclusionsIn non-diabetic ischemic stroke patients treated with intravenous thrombolysis, IR was related with worse clinical outcomes, but not with infarct volume.

The effects of zinc supplementation on metabolic profile and oxidative stress in overweight/obese patients with non-alcoholic fatty liver disease: A randomized, double-blind, placebo-controlled trial

BackgroundEvidence indicates the positive effects of zinc on insulin resistance and oxidative stress in metabolic syndrome or diabetes. Non-alcoholic fatty liver disease (NAFLD) is the main hepatic manifestation of insulin resistance and metabolic syndrome. The present study is the first clinical trial that evaluated the effects of zinc supplementation on metabolic and oxidative stress status in overweight/obese patients with NAFLD undergoing calorie- restriction diet. Methods: Fifty six overweight/obese patients with confirmed mild to moderate NAFLD using ultrasonography were randomly allocated to receive 30 mg elemental zinc supplement (n = 29) or placebo (n = 27) along with weight loss diet for 12 weeks. Serum levels of zinc, homeostasis model of assessment-estimated insulin resistance (HOMA-IR), lipid profile, serum superoxide dismutas1 (SOD1) and malondialdhyde (MDA) levels were assessed. ResultsSerum levels of insulin, SOD1, MDA and HOMA-IR were improved in the treatment group (p < 0.05). Within group comparison showed significant reduction in serum FBS, HbA1C, TC, LDL-c and TG in the treatment group. Conclusion: Zinc supplementation for three months improved insulin resistance and oxidative stress status in overweight/obese NAFLD patients with no beneficial effects on lipid profiles over weight loss diet. Registration ID in IRCT (IRCT NO: 20181005041238N1).

The effects of personalized sprint interval training and combined aerobic endurance and resistance training on insulin resistance and glycated hemoglobin in women with type 2 diabetes

Background and aims: Exercise training is a well-established therapeutic tool for treating type 2 diabetes. The purpose of this study is to examine the beneficial effects of personalized sprint interval training (SIT) and combined aerobic endurance and resistance training (Com) on insulin resistance and glycated hemoglobin A1c (HbA1c) concentration in women with type 2 diabetes. Methods: Fifty-two overweight female type 2 diabetic patients (age 45-60 years and body mass index [BMI] &gt; 30) with HbA1c value of 6.5% or higher and fasting blood glucose (FBG) ≥ 126 mg/dL (7.0 mmol/L) were selected. Participants were recruited from patients filed in the outpatient department of Shahrekord Hospital (Shahrekord, Iran) in 2016. The participants were assigned to SIT (n=17), Com (n=17), and control groups (n=18) according to HbA1c levels. The exercises included 10 weeks of Com and SIT. Results: HbA1c concentrations decreased significantly in SIT (P=0.002) and Com (P=0.006) groups. The dependent t-test revealed that differences were significant for the FBG in the SIT groups (P&lt;0.001). Serum insulin levels showed significant increases in the SIT (P&lt;0.001) and Com (P&lt;0.001) groups. Data showed significant differences in homeostasis model assessment-estimated insulin resistance (HOMA-IR) in SIT (P&lt;0.001) and Com (P&lt;0.001) groups. The analysis of covariance (ANCOVA) test showed significant differences in serum insulin (F=3.622, P=0.02) and HOMA-IR (F=5.511, P=0.0001) levels and no significant difference in HbA1c (F=0.597, P=0.556) and FBG concentrations (F=1.853, P=0.171). Conclusion: Results highlight that individualized exercise training, independent of the mode of training, is effective in improving glycemic control in overweight patients with type 2 diabetes.

1866-P: Adipocyte Hypertrophy Is Associated with Increased Dietary Fatty Acid Storage in Adipose Tissue and Reduced Postprandial Hepatic Fatty Acid Uptake and Esterification in Humans

Introduction: Excessive exposure of lean tissues to nonesterified fatty acids (NEFA) leads to insulin resistance (IR). Adipocyte hypertrophy is associated with IR and increase in adipose tissue intracellular triglyceride lipolysis and in NEFA levels, that may contribute to hepatic steatosis and IR. The effect of adipocyte hypertrophy on postprandial hepatic NEFA flux and metabolism and dietary fatty acids (DFA) storage in adipose tissues has not been studied, however. Methods: In 28 healthy adult subjects, fat cell size (FCS) was determined via histomorphologic analysis of abdominal subcutaneous fat tissue. Adipose tissue DFA storage was measured using oral administration of 18FTHA with positron emission tomography (PET). Postprandial hepatic NEFA uptake, oxidation, and esterification were determined using intravenous 11C-palmitate with dynamic PET acquisition. Results: As expected, FCS was correlated positively with fasting glycemia (ρ=0.44, P-value=0.029), homeostasis model assessment-estimated insulin resistance (HOMA-IR) (ρ=0.43, P-value=0.049), and hepatic fat content from CT radiodensity (ρ=0.32, P-value=0.10). FCS was correlated positively with DFA storage in intra-abdominal adipose tissues (ρ=0.48, P-value=0.022) and negatively with postprandial hepatic NEFA uptake (ρ=-0.42, P-value=0.027) and esterification (ρ=-0.58, P-value=0.0080). Conclusion: Adipocyte hypertrophy is associated with increased DFA storage in intra-abdominal adipose tissues and reduced postprandial hepatic NEFA uptake and esterification, despite being associated with greater hepatic fat content, fasting glycemia and HOMA-IR. Adipocyte hypertrophy is thus associated with adipose tissue metabolic adaptation that limits the exposure of the liver to fatty acids in the postprandial period. Disclosure R. Ye: None. S. Phoenix: None. C. Noll: None. E. Montastier: None. F. Frisch: None. L. Bouffard: None. M. Amrani: None. E.E. Turcotte: None. A.C. Carpentier: Advisory Panel; Self; HLS Therapeutics, Inc. Funding Canadian Institutes of Health Research (MOP53094); Centre de recherche du CHUS; Centre d’imagerie moléculaire de Sherbrooke; Faculté de médecine et des sciences de la santé de l’Université de Sherbrooke

Protective role of lycopene against metabolic disorders induced by chronic bisphenol A exposure in rats.

This study was conducted to elucidate the ameliorative potential of lycopene (LYC) against the metabolic toxicity induced by bisphenol A (BPA) in rats. Male rats (n = 28) were divided into 4 equal groups: control group, LYC group was given lycopene (10mg/kg BW), BPA group was given 10mg/kg BW of BPA, and the last group was administered BPA and LYC at 10mg/kg via gavage for 90 consecutive days. Body weight (BW) gain, lipid profile, and total antioxidant capacity (TAC) were assessed. Oral glucose tolerance test (OGTT), homeostasis model assessment-estimated insulin resistance (HOMA-IR), thyroid hormones, interleukin-1 beta (IL-1β), leptin, and resistin were assayed. Moreover, immunohistochemistry of TNF-α was performed in adipose tissue. BPA-treated rats showed significant reduction in BW gain and deteriorations in lipid profile, TAC, OGTT, and thyroid hormones as well as significant increases in HOMA-IR, IL-1β, leptin, and resistin. While, improvement of metabolic parameters was observed when LYC was administrated with BPA. Intense TNF-α immunostaining was detected in the fat of BPA-treated rats but the intensity decreased when LYC was administrated with BPA. In conclusion, LYC ameliorated the adverse effects of BPA on metabolism through its antioxidant potential and its reduction of TNF-α expression in adipose tissue.

Correlations between Measurements of Body Adiposity and Metabolic Variables in Patients with Polycystic Ovarian Syndrome: A Case-Control Study

Abstract Objective: To study correlations between Insulin Resistance (IR) and Glucose Intolerance (GI) with body adiposity in women with Polycystic Ovary Syndrome (PCOS women) and controls. Design, patients and Methods: A case-control study, including PCOS women (n=39) matched by Body Mass Index (BMI) and age to controls (n=35). We conducted Oral Glucose Tolerance Test (OGTT, 75g glucose), Homeostasis Model Assessment-estimated Insulin Resistance index (HOMA-IR), Electrical Bioimpedance (EB), Whole Body Densitometry (DXA), anthropometric measurements, and Visceral Adiposity Index (VAI). Results: In PCOS women, HOMA-IR showed strong positive association with Fat Mass (FM, r=0.7164), Android Fat (AF, r=0.7729), and Fat/Lean Mass Ratio (FM/LM, r=0.7198) obtained by DXA and anthropometric measurements: Waist Circumference (WC, r=0.7857), Hip Circumference (HC, r=0.7104), BMI (r=0.7423) and Waist-To-Height Ratio (WHtR, r=0.7979). Moderate association was identified between OGTT and FM (r=0.5261), android fat (AF, r=0.5296), FM/LM (r=0.5296), WHtR (r=0.5065) and BMI (r=0.5156). In PCOS women, HOMAIR showed moderate positive association with FM (r=0.6220) and FM/LM (r=0.6262) and negative with LM (r=-0.6220) obtained by EB. VAI presented strong (r=0.7004) and moderate (r= 0.6356) positive correlation with HOMA-IR and OGTT, respectively, in PCOS women. Subsequently, groups were subdivided into normal weight (BMI ≤ 24.9 Kg/m2) and overweight (BMI ≥ 25.0 Kg/m2). Among normal weight PCOS women, there was moderate correlation between OGTT and AF by DXA (r = 0.5308). Conclusions: Adiposity in PCOS women could be sufficiently evaluated by BMI, WHtR, and VAI. DXA is appropriate for evaluating normal weight PCOS women due to the increased metabolic risk associated with android fat. Keywords Polycystic ovary syndrome, Glucose metabolism disorders, Whole body densitometry, Electrical bioimpedance, Anthropometric measurements